Post-Operative Glioma Segmentation via Loss Stabilization, Normalization and Subspace Attention

• URL: http://arxiv.org/abs/2607.22749v1
• Date: Thu, 23 Jul 2026 09:59:30 GMT
• Title: Post-Operative Glioma Segmentation via Loss Stabilization, Normalization and Subspace Attention
• Abstract summary: We show that the standard Generalized Dice Loss (GDL) is unstable under domain shift.<n>We propose a Subspace-Aware Class Attention (SACA) module that re-calibrates the bottleneck features and raises Enhancing Tumor (ET) sensitivity by 8%.
• Score: 46.03321798937855
• License: http://arxiv.org/licenses/nonexclusive-distrib/1.0/
• Abstract: Tracking residual tumor after surgery is essential for catching recurrence early, but automating post-operative glioma segmentation remains a difficult task. Although transformer-based architectures, such as SwinUNETR, achieved impressive results, few studies test how well they generalize across clinical protocols. In this paper, we conduct an ablation study on the MU-GLIOMA-POST and UCSF-ALPTDG datasets and show that the standard Generalized Dice Loss (GDL) is unstable under domain shift: the Whole Lesion (WL) Dice drops from 0.88 on the internal validation set to 0.73 on the external UCSF test set. To address this, we pair brain-masked percentile normalization with voxel-level contrastive learning. We also propose a Subspace-Aware Class Attention (SACA) module that re-calibrates the bottleneck features and raises Enhancing Tumor (ET) sensitivity by 8% (9.1% relative improvement) on internal validation. Ensembling these refinements with nnU-Net brings every stable configuration to a WL Dice of 0.94, and the SACA variant ensemble achieves the best boundary error (HD95) of 2.92 mm on MU-GLIOMA-POST.

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